JACOB KIRT OLSON M.D.
NPI 1225396237
Student in an Organized Health Care Education/Training Program in Loma Linda, CA

Active since April 26, 2012PECOS Enrolled
11234 ANDERSON ST, GME OFFICE CSP 21005, LOMA LINDA, CA 92354(909) 558-4289 Get Directions Write a Review

NPPES record last updated: August 4, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jacob Kirt Olson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB KIRT OLSON M.D. (NPI 1225396237) is an individual student in an organized health care education/training program in Loma Linda, California and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS and maintains a secondary practice location in Indianapolis.

NPPES Registry Identity

NPI1225396237
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACOB KIRT OLSONCredential: M.D.
Location Address11234 ANDERSON ST, GME OFFICE CSP 21005Loma Linda, CA 92354-2804
Mailing Address250 N Shadeland Ave OfcIndianapolis, IN 46219-4959
Sole ProprietorNo
Enumeration DateApril 26, 2012
Last NPPES UpdateAugust 4, 2022
NPPES CertifiedAugust 4, 2022
NPI 1225396237 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedSurgery · Pediatric SurgeryTaxonomy 2086S0120X · License 1225396237 (IN)
11234 ANDERSON ST, Loma Linda, CA 92354

Secondary Practice Location 1

Location 1705 Riley Hospital DrIndianapolis, IN 46202-5109 · Phone (317) 944-4681

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Jacob Kirt Olson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant (Surgical)
11234 ANDERSON ST, RM 2562B
LOMA LINDA, CA 92354
Pediatrics (Pediatric Emergency Medicine)
11234 ANDERSON ST, A 108
LOMA LINDA, CA 92354
Radiology (Radiation Oncology)
11234 ANDERSON ST, SUITE B-121
LOMA LINDA, CA 92354
Nurse Practitioner (Pediatrics)
11234 ANDERSON ST
LOMA LINDA, CA 92354
Nurse Practitioner (Pediatrics)
11234 ANDERSON ST, MC 5700H
LOMA LINDA, CA 92354
Internal Medicine (Cardiovascular Disease)
11234 ANDERSON ST
LOMA LINDA, CA 92354
Nurse Practitioner
11234 ANDERSON ST, ROOM 6700H
LOMA LINDA, CA 92354
Anesthesiology
11234 ANDERSON ST
LOMA LINDA, CA 92354

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1225396237, enumerated as an "individual" on April 26, 2012.

The provider is located at 11234 ANDERSON ST GME OFFICE CSP 21005 LOMA LINDA, CA 92354 and the phone number is (909) 558-4289.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.